Clinical efficacy of Trigonella foenum graecum (Fenugreek) and dry cupping therapy on intensity of pain in patients with primary dysmenorrhea



To determine the effificacy and safety of fenugreek seed and dry cupping on intensity of pain in primary dysmenorrhea.


Sixty patients with primary dysmenorrhea were enrolled in this prospective, open-labeled, randomized, standard-controlled study, conducted in the National Institute of Unani Medicine Hospital between February 2010 and April 2011. In group A (20 cases), 3 g powder of fenugreek seed (3 capsules, 1 g each) was given orally twice daily from day 1 to 3 of menstrual cycle. Group B (20 cases) received the same dose of fenugreek seed as group A along with dry cupping therapy [two 4.2-cm and one 2.5-cm cups (internal diameter)], which was applied below the umbilicus for 15 min on day 1 and day 3 of menstrual cycle for 3 consecutive months. The control group C (20 cases) was given mefenamic acid, 500 mg twice daily, on the same protocol. The reduction in menstrual pain intensity was measured with well validated Visual Analogue Scale and safety of fenugreek seed was evaluated by clinical examination and laboratory investigations.


Baseline characteristics and biochemical parameters were comparable and homogenous among all groups (P>0.05). The percentage reduction in lower abdominal pain was 66.89%, 66.49%, and 62.88% in A, B and C groups respectively at the end of the treatment. No adverse drug effects were noticed.


The fenugreek seed and dry cupping are effificacious, safe, cost effective, and well tolerated.

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  1. 1.

    Avasarala AK, Panchangam S. Dysmenorrhoea in different settings: are the rural and urban adolescent girls perceiving and managing the dysmenorrhoea problem differently? Indian J Community Med 2008;33:246–249.

    Article  PubMed  PubMed Central  Google Scholar 

  2. 2.

    Proctor M, Farquhar C. Diagnosis and management of dysmenorrhoea. BMJ 2006;332:1134–1138.

    Article  PubMed  PubMed Central  Google Scholar 

  3. 3.

    Daley AJ. Exercise and primary dysmenorrhea a comprehensive and critical review of the literature. Sports Med 2008;38:659–670.

    Article  PubMed  Google Scholar 

  4. 4.

    Li N, Liu H, Chen C, Yang F, Li Z, Fang Z. CYP1A1 gene polymorphisms inmodifying association between passive smoking and primary dysmenorrhea. Ann Epidemiol 2007;17:882–888.

    Article  PubMed  PubMed Central  Google Scholar 

  5. 5.

    Spears LG. A narrative review of medical, chiropractic, and alternative health practices in the treatment of primary dysmenorrhea. J Chiropractic Med 2005;4:76–88.

    Article  Google Scholar 

  6. 6.

    Daniels SE, Torri S, Desjardins PJ. Valdecoxib for treatment of primary dysmenorrhea. A randomized double blind comparision with placebo and naporoxin. J Gen Intern Med 2005;20:62–67.

    Google Scholar 

  7. 7.

    Nejad VM, Asadipour M. Comparison of the effectiveness of fennel and mefenamic acid on pain intensity in dysmenorrhoea. East Med Health J 2006;12:423–427.

    Google Scholar 

  8. 8.

    Dawood MY, Dawood FS. Clinical efficacy and differential inhibition of menstrual fluid prostaglandin F2a in a randomized, double-blind, crossover treatment with placebo, acetaminophen, and ibuprofen in primary dysmenorrhea. Am J Obstet Gynecol 2007;196:351–355.

    Article  Google Scholar 

  9. 9.

    Sina I. Al Qanoon Fit Tib. Vol. (Urdu translation by Kantoori GH); New Delhi: Idara Kitabul Shifa; 2007:227,260, 291,312,331,340,342,374.

    Google Scholar 

  10. 10.

    Hasan A. Kitabe Mukhtarate Fit Tib. Vol. New Delhi: Central Council for Research in Unani Medicine; 2005:140,141,292,781.

    Google Scholar 

  11. 11.

    Khan A. Haziq. Pakistan: Madina Publishing Company; 1983:467–469.

    Google Scholar 

  12. 12.

    Rushd I. Kitabul Kulliyat. Vol. New Delhi: Central Council for Research in Unani Medicine; 1987:56,87,114, 115,116,129,194,210,426.

    Google Scholar 

  13. 13.

    Dawood MY. Primary dysmenorrhea advances in pathogenesis and management. ACOG 2006;108:428–441.

    Google Scholar 

  14. 14.

    Yeh LL, Liu JY, Lin KS, Liu YS, Chiou JM, Liang KY, et al. A randomized placebo-controlled trial of a traditional Chinese herbal formula in the treatment of primary dysmenorrhea. Plos ONE 2007;2:e719.

    Article  PubMed  PubMed Central  Google Scholar 

  15. 15.

    Anonymous. Hamdard pharmacopoeia of Eastern medicine. 2nd ed. Delhi: Sri Sat guru Publication; 1970:42,45,46.

    Google Scholar 

  16. 16.

    Mohammed AH. Bustanul Mufradat. Delhi: Idarae Kitabus Shifa; 2002:572–573.

    Google Scholar 

  17. 17.

    Ammar M, Alokbi Y, Mohammed A. Study of anti-inflammatory effect of some medicinal edible plants growing in Egypt. J Islamic Academy Sci 1997;10:113–122.

    Google Scholar 

  18. 18.

    Malviya KG, Bhabulkar MW, Mali PY, Rangari D. Evaluation of analgesic potential of TFG seeds in rats by using tail flick method. J Pharm Res 2010;3:1680–1681.

    Google Scholar 

  19. 19.

    Rohini R. Diuretic effect of Trigonella foenum graecum seed extracts. Int J Alternat Med 2009;6(2):1–4.

    Google Scholar 

  20. 20.

    Hafeez B, Haque R, Parvez S, Pandey S, Sayeed I, Raisuddin S. Immunomodulatory effects of fenugreek extract in mice. Int Immunopharm 2003;3:257–265.

    Article  Google Scholar 

  21. 21.

    Qamri A, Muna G. Tarjumae Minhajul Ilaj. New Delhi: Central Council for Research in Unani Medicine; 2008:410.

    Google Scholar 

  22. 22.

    Ullah K, Younis A, Wali M. An investigation into the effect of cupping therapy as a treatment for anterior knee pain and its potential role in health promotion. Int J Alternative Med 2007;4(1):1–9.

    Google Scholar 

  23. 23.

    Sultana A, Rahman K, Farzana MUZN, Lone A. Efficacy of Hijamat bila Shurt (Dry Cupping) on intensity of pain in dysmenorrhoea: A preliminary study. Anc Sci Life 2010;30:20–23.

    Google Scholar 

  24. 24.

    Vance AR, Hayes SH, Spielholz NI. Micro diathermy treatment for primary dysmenorrhea. Physl Ther 1996;76:1003–1008.

    CAS  Google Scholar 

  25. 25.

    Beecher HK. The powerful placebo. JAMA 1995;159: 1602–1605.

    Article  Google Scholar 

  26. 26.

    Frattini C, Bicchi C, Barettini, Nano GM. Volatile flavor components of licorice. J Agric Food Chem 1977;25:1238–1241.

    CAS  Article  Google Scholar 

  27. 27.

    Shah MH. The general principles of Avicenna's Cannon of Medicine. Vol. I, 2nd ed. Karachi: Interservice Presco; 1998: 204, 408.

    Google Scholar 

  28. 28.

    Wallis LA, Kasper AS, Brown W, Gordon G, Oril R, Barbo D. Textbook of women's health. Philadelphia: Lippincott Raven Publishers; 1998:471.

    Google Scholar 

  29. 29.

    Guyton AC, Hall JE. Text book of medical physiology. 10th ed. Philadelphia: Saunder Publication; 2000:557.

    Google Scholar 

  30. 30.

    Morrow C, Naumburg EH. Dysmenorrhea primary care. Clin OffPract 2009:36:19–32.

    Google Scholar 

  31. 31.

    Yusuff MD. Primary dysmenorrhoea. Advances in pathogenesis and management. Obstet Gynocol 2006;2:428–433.

    Google Scholar 

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Correspondence to Arshiya Sultana.

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Inanmdar, W., Sultana, A., Mubeen, U. et al. Clinical efficacy of Trigonella foenum graecum (Fenugreek) and dry cupping therapy on intensity of pain in patients with primary dysmenorrhea. Chin. J. Integr. Med. (2016).

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  • randomized
  • standard-controlled trial
  • Fenugreek (Hulba)
  • Hijamat bila shurt (dry cupping)
  • primary dysmenorrhea
  • Visual Analogue Scale for pain intensity